tinnitus, ringing in the ears

Tinnitus and Acupuncture

Japanese acupuncture techniques are sometimes very helpful treatments for tinnitus. Tinnitus, or "ringing in the ears", is a disturbing symptom in which it seems as if a constant humming, ringing, or buzzing affects one, or both ears. A variation of this symptom is a blowing or "swooshing" sound in the ear that coincides with the pulsebeat. If you have considered traditional medicine techniques such as acupuncture and herbal medicine for this problem, you can find more information on acupuncture and herbal medicine at our website.

The treatment of tinnitus can be very frustrating, however, because the reasons for this disorder are often not known. Most patients who suffer from ringing in the ear are told that their problem is idiopathic, which means that the cause of the tinnitus is unclear, speculative, or unknown. It is important when you develop tinnitus that you consult a physician, ear, nose and throat specialist, doctor of audiology, audiologist, or osteopath that is capable of evaluating tinnitus.

There are many diseases, infections and immune disorders that may be associated with the symptom of tinnitus, some of which are extremely dangerous and life threatening. Some of these can be treated if the diagnosis is known, so it is important to see someone with the experience and qualifications to pursue advanced evaluation and treatment.

Bacterial, acute viral and fungal infections in and around the brain and the meninges (meningitis) can cause tinnitus because a variety of structures within the head and neck are responsible for the sense of hearing. Some of these conditions appear abruptly, with acute and serious symptoms that obviously suggest the need for immediate medical evaluation and treatment.

There are also parasitic and chronic bacterial and fungal infections that are associated with a tinnitus that develops over time, especially in certain areas of the U.S. where fungal infections from soil fungi are a risk. Patients may also develop tinnitus when they suffer from diseases that are associated with foreign travel as well as with immigrants and citizens who are infected with tuberculosis, leprosy, or parasitic diseases.

Tinnitus can be associated with disorders of cranial nerves, most often the eighth, but occasionally other nerves which are physically close to the eighth nerve.

Tumors, both benign and malignant near or on the eighth nerve, around and within the brain, or around or within the organs of the ear itself can result in ringing in the ear, vertigo, loss of balance, changes in hearing, or nausea. Strokes and vascular disorders will also produce the same result if they affect these structures.

Such problems can be diagnosed, and this is the reason that a competent professional should be consulted and a full diagnostic workup be completed to evaluate these possibilities.

Many drugs can damage the hearing apparatus, or through other mechanisms contribute or cause tinnitus.It is likely that some combinations of drugs, less toxic on their own, may combine to cause tinnitus, or certain predisposing conditions and diseases may make the patient more vulnerable to this complication of drug treatment. The present way in which drugs are tested makes it impossible to know about the additive effects of different factors to cause tinnitus, nor is it possible to determine whether the effect is temporary or permanent.

Fortunately or unfortunately, there are a large number of patients with tinnitus for whom no specific diagnosis can be made. These patients, told that their problem cannot be specifically treated, and so are left with a hodge podge of various options, none of which are as satisfactory as we would like. In this article I will review some of the most likely to be enountered by the tinnitus sufferer.

Common Explanations for Idiopathic Tinnitus

The speculative reasons for tinnitus are legion: one of the more common is to suggest that ringing in the ear is associated with decreased hearing that results from exposure to loud noises or loss of hearing with age related disorders.

Changes in the small bones of the inner ear are thought by some researchers to lead to tinnitus. These can be a result of bony diseases that affect bones in general such as osteoporosis, osteosclerois, Paget's disease, rheumatoid and other forms of arthritis.

Some widely prescribed medications can cause damage to the inner ears and this can result in tinnitus.

I have also seen tinnitus as the result of a concussion or blow to the head. There are also patterns of imbalance in the acupuncture channels which are associated with tinnitus, which require training in Oriental medicine to diagnose.

What Are the Options for the Treatment of Tinnitus?

As noted previously, if a drug that causes ringing in the ears is discontinued, the ringing may in some cases improve. So it will be with successful treatment of diseases that cause tinnitus.

Some nutritional diseases and deficiencies may produce tinnitus, but unless these are specifically diagnosed and treated, there is very little evidence that supplements or vitamins will help. Nonetheless, a vast number of proprietary and dietary supplements and vitamins have been promoted as treatment. The evidence for these formulations is sparse, however, and many of the proprietary products suffer from dubious theories, sensational marketing, and high prices.

What is the Role of Acupuncture and Oriental Medicine in the Treatment of Tinnitus?

Whereas Western medicine has few solutions to the problems of tinnitus, acupuncture and herbal medicines can sometimes be very helpful. We always suggest an evaluation for acupuncture and moxibustion early in the course of the disease, as we have found that with the passage of time, the problem becomes more complex, and treatment is more prolonged and difficult.

Tinnitus associated with concussion or head injury is especially responsive if treatment is applied soon after the injury, preferably within 48 hours. Any injury in which there is loss of consciousness, or the patient become confused, or has neurologic symptoms or signs, or sees "stars", should be evaluated for concussion. Falls, sports injuries and motor vehicle accidents can be responsible for trauma to the head and neck, or the organs responsible for hearing. These patients often require immediate evaluation in an emergency room, but when possible and appropriate, acupuncture should be considered. Unfortunately, very few acute care hospitals and emergency rooms in the United States have practitioners trained in Oriental medicine available, and in-hospital treatment for injuries may of necessity delay the option to seek out an outpatient solution.

Chronic and idiopathic forms of tinnitus are difficult to treat with acupuncture, moxibustion and Chinese dietary therapy. In my experience, some of these patients have done well, but the majority have a difficult time. Chinese medical theory regards tinnitus as the result of one of several possible imbalances, but I have not found these theories to be of much value when it comes to actually determining what treatments will work. If a clear Oriental diagnosis can be made, expectation of overall improvement with treatment is reasonable, even if the tinnitus is not itself reduced. If acupuncture or Chinese medicine is going to be helpful, I suggest that patients should see some improvement within the first 6 treatments. Otherwise, the chance of success is significantly less.

There is a disorder known as stapedius syndrome or tensor tympani syndrome. Not really a type of tinnitus, the symptom that the patient experiences is a regular or irregular "tapping" sound in the ear. This is extremely annoying, and this disorder is thought to be a result of uncontrolled contractions or myoclonus of these muscles that connect to structures in the middle ear.

I have only diagnosed this syndrome once in my practice, and it rapidly responded to tuina and has remained in remission for at least the last four years, bu this is all I can say about that condition.

Hypnosis and Meditation for Tinnitus

Learning self hypnosis or meditational techniques provides another tool that a patient can use for a variety of painful and unpleasant conditions. Hypnosis and meditational systems have much in common with regard to the methods of training and the results achieved. People who train themselves in Oriental systems of meditation often are interested to change their reactions to thoughts and emotions, ultimately with the goals of eliminating thoughts and habit patterns that create suffering, while reinforcing and augmenting the thoughts and habit patterns that lead to happiness.

Inasmuch as pain represents both a sensory stimulus as well as a component of suffering, mediational techniques can be appropriately used in the treatment of a wide variety of sensory and cognitive disorders, including pain.

Tinnitus itself is rarely painful, although painful conditions can include tinnitus as part of the syndrome. Nonetheless, most paients who have tinnitus will describe their condition as annoying or unpleasant, aside from the interference that ringing in the ears provides to everday function. In that sense, tinnitus is a condition that causes suffering even when there is not the conventional association with pain. Hypnosis and meditational techniques, when correctly applied, can reduce the suffering of tinnitus, as well as another aspect of hypnotic phenomena that is very helpful when treaing tinnitus.

Hypnotic training allows a person to develop more control over their abilities to focus and eliminate distractions. Most of us can already recall many times a day when a noise around us becomes less intrusive just because we are not paying attention to it. There are many noises that a person can be aware of during sleep, but because of familiarity and insight, they rarely lead to awakening. These natural experiences can be enhanced with training, and a patient can learn to use a variety of hypnotic or meditational skills to reduce both the experience of the tinnitus as well as the suffering that it causes.

If you naturally daydream or are able to focus intently on a book or a conversation and not pay attention to what is going on around you, it is likely that you are a good hypnoic subject. Contrary to popular mythology, the more imaginative and intelligent you care, the easier it is to develop these skills. Children are especially good subjects, as their imaginative talents have not atrophied or been supressed as I sometimes see in adults.

What Other Treatments are Helpful for Idiopathic Tinnitus?

White, pink, and grey noise generators have been helpful for some people who have tinnitus. Sometimes cognitive behavioral therapy has been helpful. My suggestion is that if the condition cannot be treated directly by acupuncture and Chinese medicine, patients should learn self hypnosis to reduce the experience and discomfort of the condition.

Dr. L.B. Grotte, M.D., was the first physician in Ohio to be board certified in both acupuncture and Chinese herbology. He has studied Oriental medicine since 1972 and has practiced Oriental medicine in Cleveland since 1980. Our small practice specializes in creating individualized treatment plans combining Western and Oriental methods. Call us at 440-461-7488 to make an appointment or visit our website for more information.

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